- 18 hours ago
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00:00This programme examines dermatological conditions and the procedures involved with treating them.
00:05Due to their graphic nature, viewer discretion is advised.
00:10This is it.
00:12Oh!
00:14Hi, I'm Dr.
00:15Peter, Emma.
00:16Do you mind if we have a look at it?
00:18Well, it is a big sticker order of a great...
00:20..for it, isn't it?
00:21Yeah.
00:22It's red and it is...
00:25..angry.
00:26We have to stop it spreading.
00:28This one is the painful one.
00:29It's almost like...
00:30..like a red hop.
00:31Big needles just being stuck in.
00:33Every day I see people in...
00:35..and it's all because of their skin.
00:37It's been 20 years since they are just getting...
00:40..bigger and bigger.
00:41Some of the patients have been suffering in silence for many years.
00:45It's super light.
00:46I don't want it.
00:47And others have tried multiple treatments.
00:50And nothing has worked.
00:52And that's why they come to see me.
00:55I can't wait to have it gone.
00:56It's just going to change everything.
00:58I treat everything...
01:00..from the most extraordinary and extreme.
01:03Well, there's certainly a lot here, isn't there?
01:05I try not to look at it, to be honest.
01:07To the common skin conditions that we see every day.
01:10Whoo!
01:11That was a good one.
01:13Do you want to see this?
01:14Yeah.
01:15Oh!
01:16It is hard at the moment because resources...
01:20..are stretched and people aren't able to get the treatment...
01:23..that they need.
01:24Did I?
01:25Oh, good riddance.
01:26..and all I want to do is to help make a difference.
01:30Thank you so much.
01:31Oh, it's my pleasure.
01:32It's gone.
01:33It's gone.
01:34It's gone.
01:35That is me!
01:35What do you think?
01:36I am so grateful.
01:37You just don't know what you've done.
01:40See you again.
01:41Yeah.
01:428 million people are paying for the treatment for death and...
01:55Have you got your pack?
02:00Yeah, about a year.
02:04Start the day.
02:05Yeah.
02:10If I had to describe...
02:15My condition, it's like an alien's invaded me and I didn't invite it, I wanted to...
02:20Go away.
02:21Hi, my name's Lisa.
02:22I'm here to see Dr. Emma.
02:23Yeah, lovely.
02:24Would you like to take a seat?
02:26Lisa has just lost all her confidence.
02:30I know it's affecting her.
02:34I'm just kind of...
02:35Closing in on myself and shutting myself away.
02:40Hi, Lisa.
02:41Hi.
02:42Nice to meet you.
02:43I'm Dr. Emma.
02:44Do you want to come with me?
02:45We're just going down here.
02:48Come and have a seat.
02:50She's just up on the bed and this is Nurse Rosie.
02:52Hi.
02:53How are you?
02:54Hi.
02:55How are you?
02:55What have you come to see us about today?
02:56I've come to see you about a skin condition.
02:59So they're like...
03:00Lumps and bumps and blemishes.
03:02There used to be a few on my back.
03:04Now they're creeping all...
03:05All over my body.
03:06Yeah.
03:07And I'm just petrified they're going to be on my face at some point.
03:09Or my hands.
03:10And her...
03:10How long has it been there?
03:12About 20...
03:13Looking back about 25 to 30 years.
03:15Some of them are small.
03:16Some of them are quite big.
03:18Some of them get crusty.
03:20Scaly.
03:21They crack open.
03:22They can weep.
03:23They keep me awake most nights.
03:25I'd go to the doctor.
03:26They'd say it was nothing really important.
03:28So you really haven't had any...
03:30help in managing these at all.
03:31No.
03:32How do they make you feel about your...
03:35self?
03:36Well it was my first holiday abroad a couple of weeks ago.
03:38Couldn't go swimming.
03:39Couldn't sit by the pool.
03:40I was like fixated on looking at everybody's skin.
03:43Everybody's skin looked perfect.
03:45No one would have understood because I was just...
03:48the one that looked odd.
03:49Yeah.
03:50This sounds like it's having a big big impact.
03:55on everything that you're doing.
03:56Yeah.
03:57Yeah.
03:58Okay well I'm going to get you into a gown.
04:00if that's okay and we can have a look at everything.
04:01Okay.
04:05So the main amount of this is really on the back?
04:08Yeah mainly on the back.
04:11Well there's certainly a lot here isn't there?
04:14It's horrible yeah.
04:15I try not to look at it to be honest.
04:17Well I don't think it's horrible.
04:19I think it's...
04:20beautiful but...
04:21It's quite marvellous actually.
04:23I don't find it...
04:25horrible in the slightest.
04:26They're quite beautiful if you look at them.
04:29Yeah.
04:30You know if you look at this one in particular you can just see this really cerebral...
04:35form pattern.
04:36They almost look like whenever you're looking down on top of them like a little...
04:40brain the way the pattern often goes.
04:42Yeah.
04:43Do you mind if I have a little peek to...
04:45see them coming around the side as well?
04:47Is that okay?
04:48Oh yeah.
04:49This one is really painful.
04:50This one is the painful one?
04:51Yeah.
04:52Okay so this is most definitely...
04:55seborrheic keratosis and is probably one of the most extensive cases that I've...
05:00seen.
05:01A seborrheic keratosis is a...
05:05completely benign warty type of a growth that appears on the skin.
05:09About...
05:1090% of the population over the age of 40 will have one or two or maybe more.
05:15of the seborrheic keratosis but there are some people who seem to be more prone to...
05:20getting a lot of them like Lisa and this is probably due to a clonal mutation...
05:25so a genetic inherited pattern.
05:29When we think about...
05:30seborrheic keratosis they're considered as benign conditions but you know...
05:35this is having a significant impact on your quality of life.
05:39So I think you won't really...
05:40get rid of these.
05:41Yeah.
05:42There's a lot of them as you know and I think we'll need to...
05:45divide this up into at least three treatment sessions.
05:48Okay.
05:49And I think today what we're going to...
05:50do is these ones that are painful.
05:52Yeah.
05:53And the bigger ones that are...
05:55are on the back.
05:56Is that okay?
05:57Yeah it's amazing.
05:58Well I'd have been happy if it was just diagnosed.
06:00Yeah.
06:01Yeah.
06:02Yeah.
06:03Well we're not letting you leave.
06:04That's too much fun.
06:05Yeah.
06:06Okay.
06:07Good.
06:08We'll get you through for surgery then.
06:09Thank you so much.
06:10Thank you so much.
06:15Okay so we put a little bit of anesthetic.
06:20You're going to feel a little tiny scratch.
06:22Little scratch.
06:23Well done.
06:24There are a lot of...
06:25seboreric keratosis on Lisa's back.
06:28So Rosie and I are going to...
06:30divide and conquer.
06:31And again deep breath in.
06:32And it means that Lisa just has to lie there.
06:35for half the amount of time.
06:40You just have to leave.
06:41Yeah.
06:42What the fuck?
06:43It's all accessing the skin until there?
06:44You clearly can't have it.
06:45I'm sorry.
06:46You thought it was laid down here?
06:47And then?
06:48I could wait to get into it.
06:49I could've opened it to пока.
06:50Let's check out how come along the next day...
06:51I'm back and see you.
06:52I would be fine.
06:53Yeah.
06:54I need to share it with you.
06:55Actually, overall, I was amazed at this...
06:57Oh, my god, peed my face, everybody knows....
06:59Really?
07:01I'm happy I don't think...
07:02Do you feel like it's happened initially?
07:03I'm happy you haven't...
07:04...can't you got to harm me?
07:07i can't believe.
07:08Yeah, it's nice.
07:09I'm happy when I'm happy.
06:45If you feel anything sharp or sore or uncomfortable,
06:47your job is just to let me know, okay?
06:50This technique is called curatage.
06:54We just essentially...
06:55...scrape them down and seal it off with a little bit of heat.
07:00You're going to hear a vacuumy cleanery.
07:05It's designed.
07:06Mm-hmm.
07:10...
07:20Are you doing okay then, Lisa?
07:21Absolutely fine.
07:30When I was looking online, to me, it sounded like it was a building.
07:35We've been using exfoliators and exfoliator mittens.
07:38Okay.
07:40It's actually a live skin.
07:41It's just a buildup or an increased amount of the...
07:45the living cells, so rubbing them can actually make them worse.
07:48Okay, so that's one thing we would.
07:50I'm not doing wrong then.
07:50Yeah.
07:54Are we going to...
07:55I'm going to take a photograph.
07:55Obviously, it's quite hard for you to see.
08:00So these are the ones that we've highlighted and picked out.
08:05I like these bigger ones.
08:06So there we go.
08:07Oh my God.
08:08So all those big, nasty...
08:10horrible ones are all gone.
08:12Wow.
08:13So that's 50 in total.
08:15So when you come the next time, I'm going to do this big dipper.
08:20And then we'll do all these wee tiny ones with...
08:25Are they happy tears?
08:28Good.
08:30I don't think it's sunk in yet, so...
08:35Everything that's red is essentially...
08:40a very superficial graze to the skin.
08:42That'll take probably around about 10 days.
08:45until it's all healed over.
08:46And then it should just blend in with the rest of her skin.
08:49So the idea about...
08:50What's behind starting to remove them by surgery and destroying them is that we can clear away...
08:55a whole lot of them and then it makes it a little bit easier.
08:58So in the future, she'll just have to...
09:00have a little bit done at a time to keep this under control.
09:05And I'll give you one another example...
09:06Thank you so much.
09:08I'll give you one anotherizo video...
09:10You
09:15I'll see you next time.
09:20It's horrible to wake up each morning going to the bathroom.
09:25I have to pass the mirror and immediately I see this horrible lump.
09:30Oh, it's just horrible.
09:32It's not meant to be there.
09:34It looks like...
09:35You've got something wrong with me.
09:38It's just ugly.
09:40I hate it.
09:40It makes me miserable.
09:45It's upsetting to see...
09:50I see my mum, you know, feeling down about things.
09:54Oh, darling!
09:55Yes, mummy, because my shoulder's hurting.
09:58It can be really decided.
10:00And she copes with things so well, but I think, you know, deep down it does affect...
10:05All I want is it for to be gone.
10:10I'm sorry.
10:11I'm sorry.
10:13You've got to.
10:15It's not something to watch.
10:16It's not something to watch.
10:17It's not something to watch.
10:19It's funny.
10:20One thing.
10:21I know you shouldn't worry about what happened.
10:26I don't know what people think, but I do worry.
10:31I'm nervous.
10:32I know.
10:33You look nervous this morning.
10:34I'm not scared about you.
10:36I don't know anything that's going to happen.
10:38It's just like, oh, I can't believe this is happening to me.
10:41I'm going to meet Dr. Emma.
10:43Hi, Dawn.
10:44Hi.
10:45Hi, how are you?
10:46I'm...
10:46Bye, thank you.
10:47Nice to meet you.
10:48Hello.
10:49Come with me.
10:52This is Mottie.
10:53Hello.
10:54He's our nurse.
10:55Emma's still John.
10:56What have you come to the clinic to tell us about today?
10:58I've got a massive lipoma on my back.
11:01OK, when did it first come?
11:03Oh, over ten years ago.
11:05And it was about...
11:06The size of a walnut.
11:07But now it's like the size of an apple.
11:09A grapefruit.
11:10I love how we all...
11:11measure things by food.
11:12Just before lunch, it's all about food.
11:16Do you mind if we have a look at it?
11:17Is that OK?
11:18No, it's fine.
11:19Yes.
11:22Well, it is a big sticker order of a grapefruit, isn't it?
11:25If you like.
11:26I like it.
11:27Oh, that's very mobile, isn't it?
11:29Yeah.
11:30It's quite a...
11:31a squishy lipoma.
11:32The only thing is, it looks like this little fly.
11:36a unicorn is actually head-butting a football or something.
11:41We're just going to take a measurement of this, if that's OK?
11:43OK.
11:44Yeah.
11:45So I think if we measure...
11:46do this directly across, it's going to be 13 by...
11:5112.
11:5212?
11:53As the GP said...
11:56it is impressive.
11:57This is definitely a lipoma.
12:01A lipoma is a benign tumour that's made up of fat tissue, and it feels like a...
12:06pretty nice lipoma because it's moving...
12:08To you.
12:09To me.
12:10Come on, it feels nice.
12:11Nice to you as well.
12:12You do like the feel of it.
12:13I do like that tattoo.
12:14Yeah.
12:15So you'd be quite happy.
12:16for us to take the lump and leave a scar?
12:18Yeah.
12:19LAUGHTER
12:21OK.
12:22So we'll get the theatre set up for you then.
12:23OK.
12:24OK.
12:25Come with us.
12:26How did it go?
12:27Is she good?
12:28Is she good?
12:29Is she good?
12:30Is she good?
12:31Is she good?
12:31Yeah, it's brilliant.
12:33Wow.
12:34Frank's so good.
12:36So she's going to do it today?
12:38Yeah, I'm actually having it done now.
12:41I think I better go.
12:47OK, so sorry about the wee scratch.
12:49Well done.
12:50Very good.
12:51Well done indeed.
12:55Good job.
12:56Why was that?
12:57That was fun.
13:01If anything at all is sore or uncomfortable, then you...
13:06You can just let me know.
13:07OK?
13:08Yeah, OK.
13:11Yeah.
13:12Yeah.
13:13Yeah.
13:14Yeah.
13:15Yeah.
13:16Yeah.
13:17Yeah.
13:18Yeah.
13:19Yeah.
13:20Yeah.
13:22Yeah.
13:23We're not cutting anything at all here.
13:25All we're just doing is...
13:26listening up our little friend.
13:27Mm-hmm.
13:28It is wanting to come.
13:29Yeah.
13:30Little Lobby.
13:31Lobulated one.
13:32So lobulated means full of lobules.
13:34A bit like a Clyde in the...
13:36Sky.
13:37You know?
13:38Ha!
13:39What?
13:40Woo!
13:41That was a good one.
13:42Ha!
13:43That's what it means by the lobulated little bits.
13:46Gonna squeeze?
13:47Yeah.
13:48Body's the best at squeezing.
13:49Ha!
13:50Ha!
13:51Honestly...
13:51Yeah.
13:52There's no one better.
13:53A massage.
13:54Look.
13:55She loves it.
13:56A little bit of...
13:56See how kind I am to you, Morrie?
13:58Ha!
13:59Yeah.
14:00Honestly, I do all the work and then she got to do...
14:01the best bit.
14:02That's how much I love her.
14:03Ha!
14:04Hope you like our running commentary.
14:06I do!
14:07I do!
14:08I do!
14:09These are the bits that are holding it in.
14:11really tight.
14:12I think of this as like the little hammock.
14:15Oh, right.
14:16So what we do is we go round and round and round and round and it gets...
14:21closer and closer to the little base and then out we pop.
14:25Here it comes!
14:26Yeah.
14:27Yeah.
14:28That's it.
14:29So should we do the final...
14:31squeeze.
14:32Tiny bit.
14:33That's it.
14:34There we go.
14:36Beautiful.
14:37Beautiful.
14:38Do you wanna see this?
14:39Yeah.
14:41Oh!
14:42It's loads of...
14:43Oh!
14:44It's loads of...
14:45Oh!
14:46It's loads of...
14:46blobs!
14:47Yeah!
14:48Yeah!
14:49That's globulated!
14:50Oh my god!
14:51Are you allowed to touch it?
14:52Oh yeah, you can poke it.
14:53Ooh!
14:54Ooh!
14:55Ooh!
14:56Ooh!
14:57Oh it's like that slimy stuff you get in the...
15:00you should get in the...
15:01Pops!
15:02Yeah!
15:03Squidger bat!
15:04Ha ha ha ha!
15:06So what we're gonna do now is just do the stitching.
15:10So have you got your...
15:11eye on a dress you wanna wear?
15:12No.
15:13I just...
15:14want a nice red dress.
15:15Cos I...
15:16my favourite colour's red.
15:17I could see that today.
15:18Ha ha ha!
15:19Ha ha ha!
15:20There!
15:21Yeah!
15:22Perfect!
15:23That's good!
15:24That's good!
15:25That was a really fun like...
15:30film would remove.
15:31And now we have a new Don!
15:33Oh my...
15:35I'm so glad it's gone.
15:37Dr. Emma was absolutely brilliant and lovely.
15:40And my back's flat again.
15:42Like a back should be.
15:44It's...
15:45amazing.
15:46Can't wait to go out dress shopping.
15:47Oh!
15:48Oh!
15:49Oh!
15:50Oh!
15:51Oh!
15:52Oh!
15:53Oh!
15:54Oh!
15:55Oh!
15:56Oh!
15:57Hey!
15:58Hello!
15:59I just finished setting up that...
16:00for later.
16:01Okay.
16:02I'm just looking at Lisa's back.
16:03Oh!
16:04How is it?
16:05Yeah, it's good.
16:06So she...
16:05I sent these pictures.
16:06Obviously that's the one that we started off with.
16:08Yeah, yeah, yeah.
16:09She's been amazing actually because everyone...
16:10every day she's taken a picture to show how it's healed.
16:13So that's a space of...
16:1513 days.
16:16You've then got that just kind of pale pink where they were.
16:20That will continue to get better though.
16:22Yeah.
16:23Looks good.
16:24Yeah, really good.
16:25Hmm.
16:26Yeah.
16:27Yeah.
16:28Yeah.
16:29Yeah.
16:30Yeah.
16:30I've got way of a hundred cats.
16:35I've been out for every occasion.
16:38The winter ones, funerals.
16:41Something like this.
16:42I've just bought so many over the years because...
16:45I just want to keep it covered.
16:50The condition causes me to have itchy patches on my head.
16:55It started off just a little lump, just there.
17:00And now it's spread all up here and now it's somewhere up here.
17:03This one used to cover it all.
17:05But now you can see it's growing over the top.
17:08So this one wouldn't be any good.
17:10You know, I'm just embarrassed because it's...
17:15It's not normal.
17:16People tend to stare at it.
17:18That's why I've kept it hidden.
17:20It's horrible.
17:26There's only a handful of people who actually know
17:28everybody else is hidden from.
17:30Thanks for coming.
17:32Even my family, they don't see it that often.
17:34It's just a picture.
17:35And if anything, it's spreading more than taking it away.
17:38I don't know.
17:39You haven't even seen it, have you?
17:40No.
17:41No, it's granulated.
17:42It's...
17:43It's...
17:44You know, it's mental.
17:45Well-being is obviously deteriorated.
17:48It's not my brother what I...
17:50I used to know.
17:51I've noticed when you are somewhere, you find a...
17:55corner to sit in.
17:56You think I haven't noticed?
17:58You've isolated yourself.
17:59You've sitting at...
18:00A corner certainly can speak to you.
18:02You don't have to turn your head or hopefully not try not...
18:05To show.
18:06You said yourself.
18:07You're stronger than that.
18:08Come on.
18:09You're stronger than that.
18:10He did.
18:11He got emotional tonight.
18:12He's upset about it.
18:13You don't really want to socially.
18:15communicate with anybody.
18:16He's become withdrawn.
18:18Recluse.
18:19He's the...
18:20He's the...
18:21He's the...
18:22He's the...
18:23He's the...
18:25You're stronger than that.
18:30Let's see.
18:30I've not had anything to treat this and I've been...
18:35thinking there's got to be something, somebody's got to know something about this somewhere.
18:41Hi, is it Tony?
18:42Yes.
18:43Nice to meet you, I'm Dr Emma.
18:45Come with me.
18:47Just through here.
18:49So Tony, what...
18:50What's been happening with your skin?
18:52I wish I knew.
18:53Okay.
18:55Just always there, constantly itching.
18:58And the last time I saw anybody about...
19:00When I was told there was nothing I could do.
19:02Okay.
19:03So where is it?
19:04Oh, yeah.
19:05How long have you had this for?
19:07Almost 23 years now.
19:09I had a little lump.
19:10Just come here by the side of my ear.
19:12And they said the treatment I had for me was...
19:15Some Dermabate cream.
19:17And it was just making my head itch even more than it was normal.
19:20So the only thing that you've ever been given has been the Dermabate that's strunged.
19:25Topical steroid.
19:26Yeah.
19:27And what other effect is this having on you?
19:29Do you think it's...
19:30stops you doing things or do you...
19:31Yeah, yeah, yeah.
19:32I stopped going to church there.
19:35Because obviously you have to go in and take your hat off.
19:38And do you wear a hat then every day?
19:40Because of that.
19:41Yeah, yeah.
19:42All the time.
19:43Even if people come to my house for me.
19:45Yeah.
19:46So you're wearing the hat inside?
19:47Yeah.
19:48Let's keep it covered over.
19:49So...
19:50I don't look at it.
19:51And how does it make you feel having it there?
19:53Not good.
19:55I think this is the alien part of me happening here.
19:58Is that what it feels like?
19:59Yeah.
20:00Something's taken out of that.
20:01Okay.
20:02Do you mind if I come in and have a good close-up look at it?
20:05No, no.
20:06Feel free.
20:07So you're hacked as your protector.
20:10Yeah.
20:11Yeah.
20:12Yeah.
20:13Okay.
20:15Okay.
20:16So this is where it started over here.
20:18And it's left...
20:20left a little bit of a dipped scar as it's moved.
20:25back and into the scalp.
20:27And this part here shows it really quite...
20:30nicely how inflamed it was because where there once would have been lots of...
20:35hair follicles.
20:36There's no aren't any at all.
20:38When you come to the...
20:40edges off it and it's red and it is angry and it's that red border.
20:45that's the active itchy bit.
20:47Whereas the lower part just above the ear, well it's done its itchy.
20:50part of it and now it's just in the quiet phase.
20:53But then this part here you have to remember...
20:55is about 23 years old.
20:57We don't really want to have to wait 23 years.
21:00for this one to settle.
21:01No, no, no.
21:02We need to do something to switch it off a bit more quickly.
21:05Okay, this is some...
21:10something called discoid lupus erythematosus.
21:13And it is a very unusual condition.
21:15It's essentially an inflammatory condition.
21:18And why people get it...
21:20we can't say exactly.
21:22We do know that it's obviously a genetically...
21:25related condition.
21:26And for some reason it gets switched off.
21:30and starts this inflammation within the skin.
21:33For some people, UV...
21:35does induce it.
21:36Okay.
21:37But that said,
21:38you can get it in sites that have never seen this...
21:40the sun.
21:41And it can still start there.
21:42So essentially the skin becomes so inflamed.
21:45around where the hair follicles are.
21:48So inflamed in fact that the hair...
21:50actually is...
21:51is killed.
21:52And that's why...
21:53where it has been almost like a...
21:55forest fire as it moves out.
21:57It destroys all of the hair follicles that are there.
22:00and they don't grow again.
22:01The main thing to try and do but is...
22:04to put the...
22:05fire out.
22:06Because you don't want it to be spreading...
22:07and getting bigger.
22:08And there are some...
22:09things...
22:10things that we can do...
22:11that you actually haven't had...
22:12done before.
22:13I want to give you a tablet for...
22:15first of all.
22:16Okay.
22:17I'm going to give you a...
22:18different cream to use at home.
22:20And I...
22:20I'd quite like to do steroid injection...
22:22to switch off the fire.
22:24So they're a bit like this...
22:25steroid creams that you would have had in the past...
22:27but obviously much stronger...
22:28and I'm injecting it...
22:30deep down into the area to switch it off.
22:32That's what we'd like to do from the beginning.
22:34That's what we'd like to do from the beginning.
22:35The first thing I said is...
22:36if you could stop it from spreading...
22:37it'd be the main thing.
22:38That's exactly what we have to do.
22:39We have...
22:40we have to stop it spreading.
22:45Okay.
22:46We scratch.
22:47Well done.
22:50So this is the steroid injection...
22:52just going into the skin...
22:53where this is...
22:54and we're just...
22:55going to move our way around...
22:56just slowly and gently...
22:57just putting little tiny deposits of this in.
23:00How does that feel?
23:03Good.
23:04That something's...
23:05just going in there.
23:06Oh, that's nice.
23:07Last little one.
23:08Okay.
23:09Yeah.
23:10There we go.
23:12How did you find it?
23:14There we go.
23:15How did you find it?
23:15I found it really refreshing actually.
23:17Something's actually happening there.
23:19So...
23:20I'm happy.
23:20I think you're the first person to be injected...
23:22with such a big smile on your face...
23:23with lots of steroid injections.
23:25going in.
23:26Gesundheit.
23:27Well done.
23:28What is the new new new new new new new new new new new new new new new new new new new new?
23:29Oh
23:34Rosie, do you want to come and set up with me?
23:37Oh, okay, yep. Can't do it.
23:39Why don't we just log up?
23:43Lisa's coming in.
23:44For her second treatment today and we're going to remove as many of these mediums
23:49size lesions as we can.
23:54Although we did a whole load more the last time, I think another session of just the scraping
23:58is going to be neat.
23:59Some of the big ones, yeah.
24:00Up on the shoulders and that as well.
24:02Is that okay?
24:03I was going to say it's fabulous.
24:04It's fine.
24:06It's fabulous.
24:10Do you want to stay at your side?
24:12Yeah, I'll stay at my side.
24:14How many do you have?
24:15You have more.
24:20Did you feel that?
24:21Mm-hmm.
24:22Lots of anesthetic going in.
24:25I'm going to start with vulgarisation first.
24:27Yeah.
24:29What's that called?
24:30The coterie machine.
24:32Oh, yeah.
24:33The heat of this...
24:34Loosens it up.
24:35It almost creates little gas bubbles between the lesion and the...
24:39the skin underneath so it lifts it up so it's easier just to scrape it away.
24:42Then take it away.
24:43Yeah.
24:44It's a bit hurting, yeah?
24:45The smell of burning flesh.
24:47Yeah.
24:50It smells like barbecue.
24:51Mm.
24:52Don't go to your barbecue at Rosie's.
24:53No.
24:54No.
24:57Then this is the fun back.
24:59Oh, yeah.
25:00Oh, yeah.
25:01Yeah.
25:02Oh, yeah.
25:03Oh, yeah.
25:04Oh, yeah.
25:04Oh, yeah.
25:05Oh, yeah.
25:06Oh, yeah.
25:07Oh, yeah.
25:09Oh, yeah.
25:10It's always satisfying.
25:14Oh, yeah.
25:15That's a dream one.
25:16I did about 40 here.
25:18I think I...
25:19I did 34 and then I did a few extras.
25:21So, probably about you, eh?
25:24She still has lots of small seborrheic keratoses and we're going to use the carb...
25:29dioxide laser for those in our next setting, but yeah, that was a great fun.
25:34I'm going to say, what do you say?
25:35It's beautiful.
25:36It's beautiful.
25:39It's beautiful.
25:44I've treated Tony's discoid lupus erythematosus with topical steroids and in addition...
25:49to that I've also given him a tablet by mouth. Now this will control all of the inflammation.
25:54But because he's had this condition for so long, the other areas...
25:59that were previously inflamed but now have settled, have left white marks.
26:04And these white marks are just never going to go. So I've sent him along...
26:09for some medical tattooing and what this will do is help to blend that area in.
26:14With the rest of his skin.
26:19This is like...
26:24mind-boggling to me getting ahead with a scar tattoo.
26:29Can't wait to get started.
26:33Welcome.
26:34Come on in.
26:35Take a seat for me.
26:37You've got a little bit of hypopy...
26:39pigmentation where it's lighter, it's whiter in patches.
26:41And then you've got a little bit of hyperpigmentation around.
26:44the outer edges.
26:45So what I'm thinking is we can definitely help this with medical...
26:49micro pigmentation.
26:50Now what that is, is a form of cosmetic tattooing.
26:54So it is done using a needle, but it doesn't go as deep down as a regular needle does.
26:59You'll be happy to hear.
27:00And also it's virtually pain-free and what it involves...
27:04is using pigment into the area and then building it up gradually.
27:09until you get the true results.
27:10So let's get started.
27:11I'm just going to tuck that into your shirt.
27:14So these are the pigments that I'm using.
27:18So I'm going to use the dye...
27:19darker colour on the lighter patches that you've got.
27:22And then I'll use the lighter colour.
27:24And then I've got a colour that's absolutely perfect to go...
27:29all the way over.
27:30Okay.
27:31We're ready Tony?
27:32Yep.
27:33Okay.
27:34And I'm just going to...
27:34skim that in to where it's a bit lighter.
27:39all the way through.
27:40Feeling okay?
27:41Yeah, it's fine.
27:42Now you're going to need...
27:43Yeah, it's fine.
27:44Now you're going to need...
27:44multi-sessions Tony.
27:45Very roughly, I reckon that you're looking at about...
27:49four sessions in total.
27:50So the more sessions that you have, the darker and the more...
27:54intensity and colour you'll have that will build up.
27:58And I think your...
27:59done.
28:00So do you want to take a seat up for me please Tony?
28:02Yes.
28:05And are you ready?
28:06Yes I am.
28:07Okay.
28:08Let me get the mirror for you.
28:09Anticipating.
28:10Drum roll.
28:11Yep.
28:12Drum roll.
28:13Are you ready?
28:14Yes.
28:15Here we go.
28:17Wow.
28:18Do you think let me...
28:19hand you the mirror?
28:20Oh wow, it looks like my proper skin.
28:22Once we get that colour...
28:24in and it's all sealed in...
28:26you're looking at anything from...
28:27five years of that loss.
28:29Interesting.
28:30Wow.
28:31Mm.
28:32Mm.
28:33.
28:34Mm.
28:35Mm.
28:36Mm.
28:37Mm.
28:38Mm.
28:39.
28:39Mm.
28:43Lots.
28:44Mm.
28:45produz'.
28:46Mm.
28:48.
28:44I've been engaged for three years and
28:49on your wedding day you want to feel the most beautiful that you've ever felt and I want to be able to
28:54have my hair exactly how I want, wear whatever dress I want, but the condition it's a
28:59comparison and it makes me feel really ugly.
29:09That's a beautiful dress, isn't it? I love this one.
29:14This is definitely my favourite one.
29:17I can totally see myself getting married.
29:19As much as I love it, I'm going to have to come back when this is gone.
29:24I'm going to have to come from my nest.
29:28It does affect me.
29:29Because I don't want it to be seen by other people.
29:32It's kind of gross.
29:35My condition started around six, seven years ago.
29:38It was just a small...
29:39a small blackhead.
29:40It started to turn into a lump and that's just been growing ever since.
29:44Now it's the size of a golf ball.
29:47I think we feel really...
29:49self-conscious, embarrassed.
29:52I really feel for it.
29:53I can totally...
29:54understand why she feels that way.
29:55To delay things.
29:56Because, you know, you want to...
29:59feel special on your wedding day and you want to feel beautiful.
30:05Mom!
30:07But it's time!
30:08So I live with...
30:09my fiancé, Alex,
30:11our three-year-old daughter, Ava,
30:13and my nine-month...
30:14old baby Jackson.
30:16I was pretty carefree before the condition.
30:20I've always had a lot of self-confidence in myself
30:22and ever since this has grown big...
30:24anger.
30:26It's probably affected me more than I thought something would.
30:29I was too worried about my life's my.
30:30I'm fine.
30:31I was too happy to see.
30:32It's done.
30:33We've lost a lot of self-confidence.
30:34I have a lot of self-establishment.
30:35We've lost the responsibility of my father,
30:36but we've lost a lot of self-assistence.
30:37And I'm sure we've lostly.
30:38I'm very upset that we need to keep getting people involved.
30:39We've lost people to be told by my father,
30:40and that's unfortunately,
30:41I would do so.
30:42How could the two girls...
30:43You are able to keep getting people involved?
30:45Because I have never too far.
30:46I think, I'm just 18 years old.
30:48It's an hour before I thought it would be great.
30:50And if I am happy as a surprise,
30:52what are the best?
30:53We've lost my dad.
30:55You
31:00hello is it Sharnell yes hi nice to meet you come with me I'm dr. Emma
31:05tall and glamorous in a day come and have
31:10a seat just up on the bed so Sharnell what have you come
31:15to see me about well I have a lump on the back of my neck and I'm hoping you can
31:19help me
31:20how long has it been there for around about six years started off as a
31:23little blackhead which my sister kindly popped
31:25and what came out of it at the time it was just the gunky stuff and then
31:30is it just getting bigger yeah it's gone from sort of like a pea size like a
31:33tempi piece and now
31:35it's almost like what I would call a small golf ball oh it's a good size
31:38yeah wonderful
31:40how does it affect you what kind of things does it stop you doing having
31:42this golf ball here so I very
31:45rarely wear my hair up I've worn sort of like turtlenecks in the summertime I'll
31:49wear a scarf
31:50definitely no vest tops involved anymore yeah anything I can do to just cover it
31:54up but I
31:55also really miss having my hair cut short yeah having two children they're
31:57always pulling it anyway so I like
32:00cut to Olaf but I just I don't do that anymore how does it make you feel about
32:04yourself clearly
32:05it's always on the back of my mind I mean it's stopping me from planning my
32:08wedding so is it yeah because I don't
32:10I want a hair up kind of do okay I'm definitely not booking a wedding until
32:14I've got that
32:15back on okay so I mean it's really having an impact then because it's a big
32:18thing to happen isn't it
32:20yeah and what do your children do that your children pointed out or say anything
32:23about it yeah my daughter calls it squid
32:25squishy and pokes it ah squishy yeah so is that its name it's been rebranded as it has
32:30been rebranded as well yeah yeah okay well I just want to get in and have a
32:33little look at this okay see how it is
32:35is that okay yes of course yeah oh I can see it from here yeah
32:40it is a really rather impressive one isn't it it's a juicy one do you like
32:45how the little em mole is on it as well have you seen that yeah
32:50it's just quite funny because it's almost like a little nipple or something like that
32:55on the back of my neck yeah that's what it's like
32:58and okay that's
33:00fine I mean it's really obvious this is an epiderm
33:05cyst and that is not going to go away by itself at all and it might
33:10get a little bit bigger and then it might get infected
33:13that's a pretty nasty experience to happen if it's
33:15that size gets infected so I think that for your overall health
33:20health and well-being for the long term removing it is you know by far and away the best
33:25thing to do does that sound okay that's amazing yeah good let's get you done
33:30for surgery then yeah let's go come with me
33:35you
33:40I'm just gonna do some drawing on you before you lie down. I'm not gonna
33:45feel like pop am I? No we're not hopefully gonna let it pop I'd probably rather get it out as a
33:50nice little whole one. Okay so I'm going to get you to lie now.
33:55On your front left yeah. Oops sorry. It's like I'm getting a massage.
34:00So what I'm going to do now is pop the anesthetic in okay? Okay. Now that is the
34:05slight stingy bit. It's only stingy for a wee second. Okay. Am I gonna get to see any of
34:10it being removed today? I'm hoping that you're going to be able to see it.
34:15Whenever we take it out. Okay. Sebacius or epidermoid.
34:20They are typically caused by a blockage in a follicular unit and
34:25the keratin or the dead skin cells instead of leaving the body they
34:30they're trapped within the blockage area and they just get bigger.
34:35bigger and bigger and bigger and bigger so it's like a little balloon under the skin.
34:40There's this. You can see the fist wool there.
34:45It's busting to come out. It is busting to come out but I'd rather get it all out in one.
34:50As opposed to getting the contents of it out and then taking the fist wool off.
34:55Both are fine to do but I think you might.
35:00find it a little bit more satisfying to get the whole thing out in one.
35:05But these have such delicate fist wool some of these ones so we're just going
35:10to try and see if we can free this up. Just going so slowly because it's so thin at this.
35:15point and but it's like how close can you go before.
35:20It goes pulp.
35:23I think it'll just come.
35:24Yeah.
35:25Okay so.
35:26Let's give it a.
35:31Molly straight in there.
35:34Squidgy.
35:35Hello wee squidgy.
35:36Body's going to let you have a look.
35:40Whoa.
35:41It's pretty cool huh?
35:42It's pretty big.
35:43It's pretty cool huh?
35:44It's pretty big.
35:45It's massive.
35:46You want to touch it?
35:47I kind of do.
35:48Is that gross?
35:49No no.
35:50It's not gross.
35:51It's you.
35:52Whoa.
35:54It's ugly satis-
35:55It is.
35:56It is isn't it?
35:57It is Mr. Squishy.
35:58He's coming now.
35:59It is Squishy.
36:00Yep.
36:00Go on bye bye.
36:01You're going to feel a little cold squish of.
36:05Just water okay?
36:06Okay.
36:07Just to give it a wee clean.
36:10So what we're going to do now is just do the stitching.
36:15Do this.
36:16Yeah.
36:18Ah ah.
36:19Nope mm.
36:20Okay.
36:29I'll be here to catch and eat.
36:31Okay.
36:32Who has said one of my dogs around?
36:36How do we get done?
36:37That's sweet.
36:38I may be here to keep eating.
36:39Okay, so that's you.
36:44And this is where you had the big bump and now it's gone.
36:46Oh, wow.
36:48This is the whole area.
36:49Where the big cyst was.
36:51Yeah.
36:52These are the stitches that are in.
36:53They'll just design.
36:54It's going to dissolve away.
36:55So your scar will be, it's going to be about that length.
36:57Yeah.
36:58Probably that's my neck.
36:59That's you.
37:00Flat neck.
37:01Yay.
37:02Nice tops.
37:03Haircut.
37:04That was a lot of fun because Charnel has kind of been.
37:09A model patient.
37:10She came in and showed me the most perfect epidermoid cysts in the back.
37:14of her neck.
37:15So it's very satisfying to be able to remove it in its entirety.
37:18So.
37:19Perfect.
37:20Perfect.
37:21Perfect.
37:30I'm so happy.
37:31I'm so relieved.
37:32It's gone.
37:34First thing I'm going to do is cut my hair back to the way I wanted.
37:37The second thing I'm going to do is start.
37:39look at venues and wedding dresses that I want to wear and hairstyles that I can have
37:42that go with that wedding dress.
38:05I'm looking forward to going out today without a hat.
38:09I'm so confident doing it.
38:10Let's see how it goes.
38:15So I know it's not curable.
38:16I know it's always going to be there but because it's.
38:19It's not sticking out.
38:20It's shouting look at me.
38:22It gives me a lot more confidence.
38:24I don't know to go out and do whatever I feel like doing.
38:30Let me see.
38:31Let me see.
38:32Let me see.
38:34Wow.
38:35That looks really good, hasn't it?
38:36I can see your face smiling there.
38:38Yes.
38:39Not me big brother.
38:40Not me big brother.
38:41But.
38:42Yeah.
38:44It's been over 20 years now since I've actually felt like walking around.
38:49feeling normal.
38:50Women's hats.
38:51Ah, men's hats.
38:52Men's hats.
38:53What are you looking at men's hats for?
38:55You don't need.
38:57No men's hats anymore.
38:58Look.
38:59You look good.
39:02I'll get to the top.
39:03Look.
39:04Being Tony today has been remarkable.
39:07I could instantly notice a change, your period will come.
39:12I couldn't ask for anything more, to be honest.
39:17Like a new chapter, I'm really happy with the result.
39:22So, first yoga session in months.
39:27Obviously, since before my treatment.
39:29This is the first time ever.
39:32I can actually wear what I want.
39:34I'm quite excited, to be honest.
39:37I can actually enjoy something and get the full benefit.
39:39Like I should, and if I want to.
39:42I can now, for the first time, actually look and...
39:47Be happy with what I see.
39:48The skin, especially around my shoulders and my neck.
39:51I'm actually going to be quite...
39:52I'm quite proud to show it off again now.
39:54I'm proud to tie my hair up and wear...
39:57lower top with confidence.
40:02We're just going to really connect to our breath in.
40:07In and out of the nose.
40:09I can't actually remember the last time I felt like this.
40:12Because it's just something I've lived with for so many years.
40:16Well, I can...
40:17actually do the movements without the worry of...
40:19what if someone can see this?
40:21What if someone can see that?
40:22And I'm actually doing them to full capacity rather than worrying.
40:27about covering up as well.
40:29I'm actually relaxed and enjoying it.
40:32So I look at this now as the...
40:37start of my journey.
40:38Start of having a life again.
40:41So we've...
40:42we'll be able to sort some holidays now.
40:44I know.
40:45I have been looking as well.
40:46I'm not sure.
40:47I've never done it before.
40:48But going on a cruise.
40:49Mm-hmm.
40:50I can see a big improvement.
40:51And just...
40:52just to see her be happy again.
40:54It's wonderful.
40:55To be coming out.
40:57To be coming out of the other side.
40:58Which I am now.
40:59Is...
41:00happy tears.
41:01Er...
41:02lots more smiles.
41:03Well.
41:04Shall I say cheers ladies?
41:05Here's to many more.
41:07Let's go.
41:08Emily.
41:09Yes.
41:10Let's go.
41:11Let's go.
41:12How are you doing?
41:13I'm talking all this time away.
41:14We're gonna be back next time.
41:15Let's see.
41:16Hello everybody.
41:17Hey everyone.
41:18Let's go.
41:19Let's go.
41:20I'm here.
41:21Let's go.
41:22Hey guys.
41:23Let's go.
41:25Let's go.
41:26We're going to get food.
41:27I'm not a good food.
41:28Let's go!
41:29I'm coming.
41:30I'm coming.
41:31If I'm coming.
41:32Let's go.
41:33Let's go.
41:34I'm coming.
41:35You're not a good food.
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